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Ludwin A, Martins WP, Ludwin I. Ultrasound-guided repeat intrauterine balloon dilatation for prevention of adhesions. Ultrasound Obstet Gynecol 2019; 54:566-568. [PMID: 30677188 DOI: 10.1002/uog.20223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 06/09/2023]
Affiliation(s)
- A Ludwin
- Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland
- Ludwin & Ludwin Gynecology, Private Medical Center, Krakow, Poland
| | - W P Martins
- Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- SEMEAR Fertilidade, Reproductive Medicine, Ribeirão Preto, Brazil
| | - I Ludwin
- Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland
- Ludwin & Ludwin Gynecology, Private Medical Center, Krakow, Poland
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Roy CW, Marini D, Segars WP, Seed M, Macgowan CK. Fetal XCMR: a numerical phantom for fetal cardiovascular magnetic resonance imaging. J Cardiovasc Magn Reson 2019; 21:29. [PMID: 31118056 PMCID: PMC6532268 DOI: 10.1186/s12968-019-0539-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/15/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Validating new techniques for fetal cardiovascular magnetic resonance (CMR) is challenging due to random fetal movement that precludes repeat measurements. Consequently, fetal CMR development has been largely performed using physical phantoms or postnatal volunteers. In this work, we present an open-source simulation designed to aid in the development and validation of new approaches for fetal CMR. Our approach, fetal extended Cardiac-Torso cardiovascular magnetic resonance imaging (Fetal XCMR), builds on established methods for simulating CMR acquisitions but is tailored toward the dynamic physiology of the fetal heart and body. We present comparisons between the Fetal XCMR phantom and data acquired in utero, resulting in image quality, anatomy, tissue signals and contrast. METHODS Existing extended Cardiac-Torso models are modified to create maternal and fetal anatomy, combined according to simulated motion, mapped to CMR contrast, and converted to CMR data. To provide a comparison between the proposed simulation and experimental fetal CMR images acquired in utero, images from a typical scan of a pregnant woman are included and simulated acquisitions were generated using matching CMR parameters, motion and noise levels. Three reconstruction (static, real-time, and CINE), and two motion estimation methods (translational motion, fetal heart rate) from data acquired in transverse, sagittal, coronal, and short-axis planes of the fetal heart were performed to compare to in utero acquisitions and demonstrate feasibility of the proposed simulation framework. RESULTS Overall, CMR contrast, morphologies, and relative proportions of the maternal and fetal anatomy are well represented by the Fetal XCMR images when comparing the simulation to static images acquired in utero. Additionally, visualization of maternal respiratory and fetal cardiac motion is comparable between Fetal XCMR and in utero real-time images. Finally, high quality CINE image reconstructions provide excellent delineation of fetal cardiac anatomy and temporal dynamics for both data types. CONCLUSION The fetal CMR phantom provides a new method for evaluating fetal CMR acquisition and reconstruction methods by simulating the underlying anatomy and physiology. As the field of fetal CMR continues to grow, new methods will become available and require careful validation. The fetal CMR phantom is therefore a powerful and convenient tool in the continued development of fetal cardiac imaging.
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Affiliation(s)
- Christopher W. Roy
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Vaud Switzerland
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario Canada
- Division of Translational Medicine, Peter Gilgan Centre for Research & Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
| | - Davide Marini
- Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Ontario Canada
| | - William Paul Segars
- Department of Radiology, Duke University Medical Center, Durham, North Carolina USA
| | - Mike Seed
- Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Ontario Canada
- Departments of Pediatrics and Diagnostic Imaging, University of Toronto, Toronto, Ontario Canada
| | - Christopher K. Macgowan
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario Canada
- Division of Translational Medicine, Peter Gilgan Centre for Research & Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
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da Silva NA, Vassallo J, Sarian LO, Cognard C, Sevely A. Magnetic resonance imaging of the fetal brain at 3 Tesla: Preliminary experience from a single series. Medicine (Baltimore) 2018; 97:e12602. [PMID: 30290631 PMCID: PMC6200506 DOI: 10.1097/md.0000000000012602] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 09/02/2018] [Indexed: 11/30/2022] Open
Abstract
To report our preliminary experience with cerebral fetal magnetic resonance imaging (MRI) with a 3 Tesla (3T) scanner. We assessed feasibility, time of acquisition, and possibility to establish a diagnosis.Fifty-nine pregnant women had fetal MRI performed during the third trimester of pregnancy due to clinical or sonography concern of a central nervous system anomaly. No fetal or maternal sedation was used. The MRI protocol consisted of T2 turbo-spin-echo images in 3 planes of space. No T1-weighted images were performed. All images were analyzed by 2 pediatric neuroradiologists, who evaluated spatial resolution, artifacts, time of acquisition, and possibility to establish a diagnosis suspected by sonography.Examinations were performed safely for all patients. The images required longer time of acquisition (approximately 75 seconds for each plane in the space). The specific absorption rate was not exceeded in any fetus. Cerebral fetal MRI was normal in 22 cases. The spectrum of diagnostics included isolated ventriculomegaly, posterior fossa malformation, corpus callosum malformation, gyration anomalies, craniosynostosis, tuberous sclerosis, microcephaly, external hydrocephaly, midline arachnoid cyst, cerebral lesions, and persistent hyperplastic primitive vitreous.In our series, 3 T MRI of fetal brain was feasible and able to establish a diagnosis but required longer time of acquisition.
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Affiliation(s)
- Nivaldo Adolfo da Silva
- Department of Radiology, Faculty of Medical Sciences, State University of Campinas, Campinas (UNICAMP), Campinas-SP, Brazil
- Department of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire (CHU) - Hôpital Pierre Paul Riquet, University of Toulouse, Toulouse, France
- Department of Neuroradiology, Diagnósticos da América (DASA Group), São Paulo
| | - José Vassallo
- Laboratory of Molecular and Investigative Pathology-LAPE, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Luis Otávio Sarian
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Christophe Cognard
- Department of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire (CHU) - Hôpital Pierre Paul Riquet, University of Toulouse, Toulouse, France
| | - Annick Sevely
- Department of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire (CHU) - Hôpital Pierre Paul Riquet, University of Toulouse, Toulouse, France
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Zhang H, Yang Y, Li X, Shi Y, Hu B, An Y, Zhu Z, Hong G, Yang CJ. Frequency-enhanced transferrin receptor antibody-labelled microfluidic chip (FETAL-Chip) enables efficient enrichment of circulating nucleated red blood cells for non-invasive prenatal diagnosis. Lab Chip 2018; 18:2749-2756. [PMID: 30123896 DOI: 10.1039/c8lc00650d] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fetal aneuploidy and other chromosomal aberrations affect 9 in 1000 live births. Unlike the invasive diagnosis with high risk of miscarriage, non-invasive prenatal diagnosis (NIPD) sampling from maternal blood becomes a promising way for fetal genetic screening. However, fetal cell-based NIPD has a major challenge due to the small number of fetal cells present in maternal blood. We designed a frequency-enhanced transferrin receptor antibody-labelled microfluidic chip (FETAL-Chip) for efficient enrichment and identification of circulating fetal cells, i.e., circulating nucleated red blood cells (cNRBCs) from maternal blood. The FETAL-Chip can dramatically enhance the interaction of fetal cells with antibody-coated microposts to increase the capture efficiency while minimizing nonspecific adsorption. With the help of immunostaining, we can identify cNRBCs from as little as 2 milliliter maternal blood. Various numbers of cNRBCs were detected from volunteers as early as 7 weeks after conception and throughout the entire pregnancy. Gene analysis was also carried out to confirm the fetal origin of captured cells. With easy, non-invasive and highly efficient enrichment of cNRBCs, the method presented here offers great potential for non-invasive prenatal diagnosis.
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Affiliation(s)
- Huimin Zhang
- Institute of Molecular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
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Ouyang YS, Zhang YX, Meng H, Wu XN, Qi QW. Adducted thumb as an isolated morphologic finding: an early sonographic sign of impaired neurodevelopment: A STROBE compliant study. Medicine (Baltimore) 2018; 97:e12437. [PMID: 30235725 PMCID: PMC6160029 DOI: 10.1097/md.0000000000012437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Fetal adducted thumbs have been described in association with hydrocephalus and other abnormalities, but in cases without other structural malformations the determination of prognosis and recurrence risk is challenging. The aim of our study is to analyze the characteristics, natural history, and postnatal outcome of such cases.A retrospective study was conducted over a period of 4 years in a tertiary referral center. All fetuses diagnosed as adducted thumbs without other structural malformations comprised the study group. Prenatal sonographic features and neonatal outcome are documented.There were 4 cases of fetal adducted thumbs diagnosed during the study period. No cases demonstrated other structural malformations throughout the gestation. A smaller head was noted in 2 cases during the follow-up, and all cases presented with polyhydramnios on the first or ensuing scans. Three cases died after birth due to swallowing or breathing difficulty, and the surviving 1 showed convulsion and mental retardation.Fetal adducted thumb might be an early and specific sonographic marker of impaired neurodevelopment. Close follow-up and genetic investigation should be performed in these cases. Ultrasound examination plays an important role in the prenatal diagnosis and counseling of cases without detailed prenatal genetic analysis.
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Affiliation(s)
| | | | | | | | - Qing-Wei Qi
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Antolic A, Wood CE, Keller-Wood M. Use of radiotelemetry to assess perinatal cardiac function in the ovine fetus and newborn. Am J Physiol Regul Integr Comp Physiol 2017; 313:R660-R668. [PMID: 28855176 PMCID: PMC5814690 DOI: 10.1152/ajpregu.00078.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/26/2017] [Accepted: 08/23/2017] [Indexed: 12/11/2022]
Abstract
The late gestation fetal ECG (fECG) has traditionally been difficult to characterize due to the low fECG signal relative to high maternal noise. Although new technologies have improved the feasibility of its acquisition and separation, little is known about its development in late gestation, a period in which the fetal heart undergoes extensive maturational changes. Here, we describe a method for the chronic implantation of radiotelemetry devices into late gestation ovine fetuses to characterize parameters of the fECG following surgery, throughout late gestation, and in the perinatal period. We found no significant changes in mean aortic pressure (MAP), heart rate (HR), or ECG in the 5 days following implantation; however, HR decreased in the first 24 h following the end of surgery, with associated increases in RR, PR, and QRS intervals. Over the last 14 days of fetal life, fetal MAP significantly increased, and HR significantly decreased, as expected. MAP and HR increased as labor progressed. Although there were no significant changes over time in the ECG during late gestation, the duration of the PR interval initially decreased and then increased as birth approached. These results indicate that although critical maturational changes occur in the late gestation fetal myocardium, the mechanisms that control the cardiac conduction are relatively mature in late gestation. The study demonstrates that radiotelemetry can be successfully used to assess fetal cardiac function, in particular conduction, through the process of labor and delivery, and may therefore be a useful tool for study of peripartum cardiac events.
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Affiliation(s)
- A Antolic
- Department of Pharmacodynamics, University of Florida, Gainesville, Florida;
| | - C E Wood
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, Florida; and
| | - M Keller-Wood
- Department of Pharmacodynamics, University of Florida, Gainesville, Florida
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Hudecova I, Jiang P, Davies J, Lo YMD, Kadir RA, Chiu RWK. Noninvasive detection of F8 int22h-related inversions and sequence variants in maternal plasma of hemophilia carriers. Blood 2017; 130:340-347. [PMID: 28490568 PMCID: PMC5532756 DOI: 10.1182/blood-2016-12-755017] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/19/2017] [Indexed: 12/15/2022] Open
Abstract
Direct detection of F8 and F9 sequence variants in maternal plasma of hemophilia carriers has been demonstrated by microfluidics digital PCR. Noninvasive prenatal assessment of the most clinically relevant group of sequence variants among patients with hemophilia, namely, those involving int22h-related inversions disrupting the F8 gene, poses additional challenges because of its molecular complexity. We investigated the use of droplet digital PCR (ddPCR) and targeted massively parallel sequencing (MPS) for maternal plasma DNA analysis to noninvasively determine fetal mutational status in pregnancies at risk for hemophilia. We designed family-specific ddPCR assays to detect causative sequence variants scattered across the F8 and F9 genes. A haplotype-based approach coupled with targeted MPS was applied to deduce fetal genotype by capturing a 7.6-Mb region spanning the F8 gene in carriers with int22h-related inversions. The ddPCR analysis correctly determined fetal hemophilia status in 15 at-risk pregnancies in samples obtained from 8 to 42 weeks of gestation. There were 3 unclassified samples, but no misclassification. Detailed fetal haplotype maps of the F8 gene region involving int22h-related inversions obtained through targeted MPS enabled correct diagnoses of fetal mutational status in 3 hemophilia families. Our data suggest it is feasible to apply targeted MPS to interrogate maternally inherited F8 int22h-related inversions, whereas ddPCR represents an affordable approach for the identification of F8 and F9 sequence variants in maternal plasma. These advancements may bring benefits for the pregnancy management for carriers of hemophilia sequence variants; in particular, the common F8 int22h-related inversions, associated with the most severe clinical phenotype.
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Affiliation(s)
- Irena Hudecova
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, Hong Kong, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, China; and
| | - Peiyong Jiang
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, Hong Kong, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, China; and
| | - Joanna Davies
- Department of Obstetrics and Gynaecology and
- Katharine Dormandy Haemophilia and Thrombosis Center, Royal Free Hospital, London, United Kingdom
| | - Y M Dennis Lo
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, Hong Kong, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, China; and
| | - Rezan A Kadir
- Department of Obstetrics and Gynaecology and
- Katharine Dormandy Haemophilia and Thrombosis Center, Royal Free Hospital, London, United Kingdom
| | - Rossa W K Chiu
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, Hong Kong, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, China; and
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Wu WJ, Ma GC, Lee MH, Chen YC, Chen M. Normal prenatal ultrasound findings reflect outcome in case of trisomy 14 confined placental mosaicism developing after preimplantation genetic diagnosis. Ultrasound Obstet Gynecol 2017; 50:128-130. [PMID: 27790814 DOI: 10.1002/uog.17338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/30/2016] [Accepted: 10/19/2016] [Indexed: 06/06/2023]
Affiliation(s)
- W-J Wu
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan
- Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - G-C Ma
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - M-H Lee
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan
| | - Y-C Chen
- Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan
| | - M Chen
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan
- Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
- Department of Life Science, Tunghai University, Taichung, Taiwan
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Tutschek B, Blaas HGK, Abramowicz J, Baba K, Deng J, Lee W, Merz E, Platt L, Pretorius D, Timor-Tritsch IE, Gindes L. Three-dimensional ultrasound imaging of the fetal skull and face. Ultrasound Obstet Gynecol 2017; 50:7-16. [PMID: 28229509 DOI: 10.1002/uog.17436] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 02/06/2017] [Accepted: 02/14/2017] [Indexed: 06/06/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - H-G K Blaas
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, National Center for Fetal Medicine, St Olavs Hospital, Trondheim, Norway
| | - J Abramowicz
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
| | - K Baba
- Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - J Deng
- University College London, London, UK
| | - W Lee
- Baylor College of Medicine, Obstetrics & Gynecology, Houston, TX, USA
| | - E Merz
- Krankenhaus Nordwest - Centre for Prenatal Diagnosis and Therapy, Frankfurt, Germany
| | - L Platt
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - D Pretorius
- Department of Radiology, University of California San Diego, CA, USA
| | - I E Timor-Tritsch
- Department of Obstetrics and Gynecology, NYU School of Medicine, New York, NY, USA
| | - L Gindes
- Department of Obstetrics and Gynecology, Wolfson Medical Center, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Fuchs T, Grobelak K, Pomorski M, Zimmer M. Fetal Heart Rate Monitoring Using Maternal Abdominal Surface Electrodes in Third Trimester: Can We Obtain Additional Information Other than CTG Trace? ADV CLIN EXP MED 2016; 25:309-16. [PMID: 27627565 DOI: 10.17219/acem/60842] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/12/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiotocography (CTG) is the most widely used procedure despite its low specificity for fetal acidosis and poor perinatal outcome. Fetal electrocardiography (fECG) with transabdominal electrodes is a new, non-invasive and promising method with greater potential for detecting impairment of fetal circulation. This study is the first that attempts to assess the usefulness of fECG in comparison to CTG during antepartum period. OBJECTIVES To determine if a single fECG examination along with CTG tracing and Doppler flow measurement in the fetal vessels has any additional clinical value in normal and intrauterine growth restricted (IUGR) fetuses. MATERIAL AND METHODS The study included 93 pregnancies with IUGR, 37 pregnancies with IUGR and brain sparing effect, and 324 healthy pregnant women. The T/QRS ratio, cerebro-placental ratio (CRP), and CTG tracings were analyzed. One-way analysis of variance and Spearman's rank correlation coefficient were applied. The relationship between results of the T/QRS ratio and CTG examination among the study groups was analyzed. RESULTS The highest average mean value of the T/QRS ratio was recorded in the IUGR group with a normal CPR and a pathologic CTG (0.235 ± 0.014). The highest average maximum values were observed in the groups of IUGR pregnancies with a reduced CPR with normal (0.309 ± 0.100), suspicious (0.330 ± 0.102) and pathologic (0.319 ± 0.056) CTGs. Analysis of variance revealed differences between study groups regarding maximum values and the difference between maximum and minimal values of T/QRS. Correlations between groups were insignificant. CONCLUSIONS Higher values of T/QRS ratio in IUGR pregnancies with normal and reduced CPR than in control group regardless of the result of CTG examination may indicate minimal worsening of intrauterine fetal well-being in growth retarded fetuses. No relationship between fECG examination and CTG tracings suggests that a single fECG does not provide any additional clinically significant information determining the condition of the fetus; however, further studies are required.
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Affiliation(s)
- Tomasz Fuchs
- 2nd Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Poland
| | - Krzysztof Grobelak
- 2nd Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Poland
| | - Michał Pomorski
- 2nd Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Poland
| | - Mariusz Zimmer
- 2nd Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Poland
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Zhao F, Chai D, Lu J, Yu J, Liu S. Novel chemiluminescent imaging microtiter plates for high-throughput detection of multiple serum biomarkers related to Down's syndrome via soybean peroxidase as label enzyme. Anal Bioanal Chem 2015; 407:6117-26. [PMID: 26105511 DOI: 10.1007/s00216-015-8788-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 05/05/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
Abstract
Novel chemiluminescent (CL) imaging microtiter plates with high-throughput, low-cost, and simple operation for detection of four biomarkers related to Down's syndrome screening were developed and evaluated. To enhance the sensitivity of CL immunosensing, soybean peroxidase (SBP) was used instead of horseradish peroxide (HRP) as a label enzyme. The microtiter plates were fabricated by simultaneously immobilizing four capture monoclonal antibodies, anti-inhibin-A, anti-unconjugated oestriol (anti-uE3), anti-alpha-fetoprotein (anti-AFP), and beta anti-HCG (anti-β-HCG), on nitrocellulose (NC) membrane to form immunosensing microtiter wells. Under a sandwiched immunoassay, the CL signals on each sensing site of the microtiter plates were collected by a charge-coupled device (CCD), presenting an array-based chemiluminescence imaging method for detection of four target antigens in a well at the same time. The linear response to the analyte concentration ranged from 0.1 to 40 ng/mL for inhibin-A, 0.075 to 40 ng/mL for uE3, 0.2 to 400 ng/mL for AFP, and 0.4 to 220 ng/mL for β-HCG. The proposed microtiter plates possessed high-throughput, good stability, and acceptable accuracy for detection of four antigens in clinical serum samples and demonstrated potential for practical applicability of the proposed method to Down's syndrome screening. Graphical Abstract Schematic evaluation of the microtiter plater for simultaneous detection of the four biomarkers.
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Affiliation(s)
- Fang Zhao
- Jiangsu Province Hi-Tech Key Laboratory for Bio-medical Research, Suzhou Research Institute of Southeast University, School of Chemistry and Chemical Engineering, Southeast University, Nanjing, Jiangsu, 210096, China
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Labrecque L, Provençal M, Caqueret A, Wo BL, Bujold E, Larivière F, Bédard MJ. Correlation of cord blood pH, base excess, and lactate concentration measured with a portable device for identifying fetal acidosis. J Obstet Gynaecol Can 2015; 36:598-604. [PMID: 25184978 DOI: 10.1016/s1701-2163(15)30539-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the effectiveness of portable lactate analyzers in identifying fetal acidosis by correlating arterial and venous lactate values from umbilical cord blood with lactate, pH, and base excess measurements from central laboratory analyzers. METHODS We performed a prospective study using arterial and venous cord blood from 52 women with a singleton fetus delivered at term. We evaluated the correlation between the cord blood lactate concentration measured using two of the same portable devices (Lactate Plus, Nova Biomedical) with the result from a central laboratory analyzer. Analyses of the correlation between arterial lactate concentration measured on the portable device with arterial pH and base excess were then performed. RESULTS We observed a median arterial pH of 7.24 (range 7.05 to 7.35) and a median arterial lactate concentration of 3.7 mmol/L (range 1.7 to 8.8 mmol/L). An excellent correlation was observed between lactate concentrations measured by the two portable devices (arterial R² = 0.98 and venous R² = 0.98), and between the portable device and the central laboratory analyzer (arterial R² = 0.94 and venous R² = 0.95). In our population, the optimal cut-offs to predict a pH < 7.20 or a base excess > -8.0 mmol/L were a lactate concentration of 4.9 mmol/L and 5.3 mmol/L, respectively, according to receiver operator characteristic analysis. With a lactate concentration > 4.9 mmol/L, the portable device had a sensitivity of 82% and a specificity of 90% to identify samples with an arterial pH < 7.20. CONCLUSION Cord blood lactate concentration measured with a portable device is a good predictor of cord blood base excess and pH. Future studies should be designed to correlate scalp blood lactate measurements with clinical outcomes.
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Affiliation(s)
- Lyne Labrecque
- Department of Biochemistry, Centre hospitalier de l'Université de Montréal, Montreal QC
| | - Mathieu Provençal
- Department of Biochemistry, Centre hospitalier de l'Université de Montréal, Montreal QC
| | - Aurore Caqueret
- Department of Biochemistry, Centre hospitalier de l'Université de Montréal, Montreal QC
| | - Bi Lan Wo
- Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, Montreal QC
| | - Emmanuel Bujold
- Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec QC
| | - François Larivière
- Department of Biochemistry, Centre hospitalier de l'Université de Montréal, Montreal QC
| | - Marie-Josée Bédard
- Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, Montreal QC
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14
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Abstract
BACs-on-Beads™ (BoBs™) is a new emerging technology, a modification of comparative genomic hybridization that can be used to detect DNA copy number gains and losses. Here, we describe the application of two different types of BoBs™ assays: (1) Prenatal BoBs (CE-IVD) to detect the most frequent syndromes associated with chromosome microdeletions, as well as the trisomy 13, 18 and 21, and (2) KaryoLite BoBs (RUO) which can detect aneuploidy in all chromosomes by quantifying proximal and terminal regions of each chromosomal arm. The interpretation of the results by BoBsoft™ software is also described. Although BoBs™ may not have the breadth and scope to replace chromosomal microarrays (array comparative genomic hybridization and single nucleotide polymorphism array) in the prenatal setting, particularly when a fetal anomaly has been detected, it is a well suited alternative for FISH or QF-PCR because BoBs™ is comparable, if not superior in terms of cost, turnaround time (TAT) and throughput and accuracy. BoBs™ also has the ability to detect significant fetal mosaicism (≥30% with Prenatal BoBs and ≥50% with KaryoLite BoBs). However, perhaps the greatest strength of this new technology is the fact that unlike FISH or QF-PCR, it has the ability to detect common microdeletion syndromes or additional aneuploidies, both of which may be easily missed despite excellent prenatal sonography. Thus, when BoBs™ is applied in the correct clinical setting and run and analyzed in appropriate laboratories this technique can improve and augment best practices with a personalization of prenatal care.
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MESH Headings
- Chromosome Deletion
- Chromosomes, Artificial, Bacterial/genetics
- Chromosomes, Artificial, Bacterial/metabolism
- Chromosomes, Human, Pair 13
- Chromosomes, Human, Pair 18
- Chromosomes, Human, Pair 21
- DNA Copy Number Variations
- Female
- Humans
- Male
- Mosaicism
- Precision Medicine
- Pregnancy
- Prenatal Diagnosis/instrumentation
- Prenatal Diagnosis/methods
- Software
- Trisomy/diagnosis
- Trisomy/genetics
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Affiliation(s)
- Francesca Romana Grati
- Research and Development, Cytogenetics and Molecular Biology, TOMA Advanced Biomedical Assays, S.p.A., Via Francesco Ferrer 25/27, 21052, Busto Arsizio, VA, Italy,
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15
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Woitek R, Dvorak A, Weber M, Seidl R, Bettelheim D, Schöpf V, Amann G, Brugger PC, Furtner J, Asenbaum U, Prayer D, Kasprian G. MR-based morphometry of the posterior fossa in fetuses with neural tube defects of the spine. PLoS One 2014; 9:e112585. [PMID: 25393279 PMCID: PMC4231033 DOI: 10.1371/journal.pone.0112585] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/08/2014] [Indexed: 11/24/2022] Open
Abstract
Objectives In cases of “spina bifida,” a detailed prenatal imaging assessment of the exact morphology of neural tube defects (NTD) is often limited. Due to the diverse clinical prognosis and prenatal treatment options, imaging parameters that support the prenatal differentiation between open and closed neural tube defects (ONTDs and CNTDs) are required. This fetal MR study aims to evaluate the clivus-supraocciput angle (CSA) and the maximum transverse diameter of the posterior fossa (TDPF) as morphometric parameters to aid in the reliable diagnosis of either ONTDs or CNTDs. Methods The TDPF and the CSA of 238 fetuses (20–37 GW, mean: 28.36 GW) with a normal central nervous system, 44 with ONTDS, and 13 with CNTDs (18–37 GW, mean: 24.3 GW) were retrospectively measured using T2-weighted 1.5 Tesla MR -sequences. Results Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age. In ONTDs the CSA was significantly smaller (p<.001) than in normal controls and CNTDs, whereas in CNTDs the CSA was not significantly smaller than in controls (p = .160). In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001). Conclusions The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls. This is the first study to show that the CSA changes during gestation and that it is a reliable imaging biomarker to distinguish between ONTDs and CNTDs, independent of the morphology of the spinal defect.
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Affiliation(s)
- Ramona Woitek
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - Anton Dvorak
- Public Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - Michael Weber
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Rainer Seidl
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Dieter Bettelheim
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Veronika Schöpf
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gabriele Amann
- Department of Clinical Pathology, Medical University of Vienna, Vienna, Austria
| | - Peter C. Brugger
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ulrika Asenbaum
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Daniela Prayer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gregor Kasprian
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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16
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Kantak C, Chang CP, Wong CC, Mahyuddin A, Choolani M, Rahman A. Lab-on-a-chip technology: impacting non-invasive prenatal diagnostics (NIPD) through miniaturisation. Lab Chip 2014; 14:841-854. [PMID: 24452749 DOI: 10.1039/c3lc50980j] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This paper aims to provide a concise review of non-invasive prenatal diagnostics (NIPD) to the lab-on-a-chip and microfluidics community. Having a market of over one billion dollars to explore and a plethora of applications, NIPD requires greater attention from microfluidics researchers. In this review, a complete overview of conventional diagnostic procedures including invasive as well as non-invasive (fetal cells and cell-free fetal DNA) types are discussed. Special focus is given to reviewing the recent and past microfluidic approaches to NIPD, as well as various commercial entities in NIPD. This review concludes with future challenges and ethical considerations of the field.
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Affiliation(s)
- Chaitanya Kantak
- Institute of Microelectronics, Agency for Science Technology and Research, 11 Science Park Road, Singapore Science Park 2, Singapore 117685, Singapore.
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17
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Wu H, Huang G, Romay-Penabad Z, Pierangeli S, Dong J. Do we need to worry about contamination by circulating fetal DNA? Clin Chem Lab Med 2013; 52:e75-7. [PMID: 24353144 DOI: 10.1515/cclm-2013-0726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 11/25/2013] [Indexed: 11/15/2022]
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18
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Paley MNJ, Morris JE, Jarvis D, Griffiths PD. Fetal electrocardiogram (fECG) gated MRI. Sensors (Basel) 2013; 13:11271-9. [PMID: 23979479 PMCID: PMC3821351 DOI: 10.3390/s130911271] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 08/12/2013] [Accepted: 08/22/2013] [Indexed: 11/16/2022]
Abstract
We have developed a Magnetic Resonance Imaging (MRI)-compatible system to enable gating of a scanner to the heartbeat of a foetus for cardiac, umbilical cord flow and other possible imaging applications. We performed radiofrequency safety testing prior to a fetal electrocardiogram (fECG) gated imaging study in pregnant volunteers (n = 3). A compact monitoring device with advanced software capable of reliably detecting both the maternal electrocardiogram (mECG) and fECG simultaneously was modified by the manufacturer (Monica Healthcare, Nottingham, UK) to provide an external TTL trigger signal from the detected fECG which could be used to trigger a standard 1.5 T MR (GE Healthcare, Milwaukee, WI, USA) gating system with suitable attenuation. The MR scanner was tested by triggering rapidly during image acquisition at a typical fetal heart rate (123 beats per minute) using a simulated fECG waveform fed into the gating system. Gated MR images were also acquired from volunteers who were attending for a repeat fetal Central Nervous System (CNS) examination using an additional rapid cardiac imaging sequence triggered from the measured fECG. No adverse safety effects were encountered. This is the first time fECG gating has been used with MRI and opens up a range of new possibilities to study a developing foetus.
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Affiliation(s)
- Martyn N J Paley
- Academic Radiology, Department of Cardiovascular Science, University of Sheffield, Sheffield, UK.
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19
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Nau JY. [Down syndrome: diagnose or eradicate?]. Rev Med Suisse 2012; 8:1682-1683. [PMID: 22988730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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20
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Larina IV, Syed SH, Sudheendran N, Overbeek PA, Dickinson ME, Larin KV. Optical coherence tomography for live phenotypic analysis of embryonic ocular structures in mouse models. J Biomed Opt 2012; 17:081410-1. [PMID: 23224171 PMCID: PMC3397804 DOI: 10.1117/1.jbo.17.8.081410] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 04/16/2012] [Accepted: 04/18/2012] [Indexed: 05/18/2023]
Abstract
Mouse models of ocular diseases provide a powerful resource for exploration of molecular regulation of eye development and pre-clinical studies. Availability of a live high-resolution imaging method for mouse embryonic eyes would significantly enhance longitudinal analyses and high-throughput morphological screening. We demonstrate that optical coherence tomography (OCT) can be used for live embryonic ocular imaging throughout gestation. At all studied stages, the whole eye is within the imaging distance of the system and there is a good optical contrast between the structures. We also performed OCT eye imaging in the embryonic retinoblastoma mouse model Pax6-SV40 T-antigen, which spontaneously forms lens and retinal lesions, and demonstrate that OCT allows us to clearly differentiate between the mutant and wild type phenotypes. These results demonstrate that OCTin utero imaging is a potentially useful tool to study embryonic ocular diseases in mouse models.
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Affiliation(s)
- Irina V Larina
- Baylor College of Medicine, Department of Molecular Physiology and Biophysics, One Baylor Plaza, Houston, TX 77030, USA.
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21
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Pilnick A, Zayts O. 'Let's have it tested first': choice and circumstances in decision-making following positive antenatal screening in Hong Kong. Sociol Health Illn 2012; 34:266-282. [PMID: 22085332 DOI: 10.1111/j.1467-9566.2011.01425.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There now exists a considerable body of sociological work examining antenatal screening for fetal abnormalities. A common theme emerging from this literature is that pregnant women report not feeling able to exercise choice freely, experiencing constraints both from medical professionals and their perceived expectations of the sociocultures in which they live. This study adds to existing literature in three ways. Firstly, in contrast to the existing body of interview-based research, the study uses video recordings of actual consultations, in order to capture the interactional processes through which choice and constraints are established, negotiated and contested. Secondly, it explores the next stage in the process of antenatal screening, by focusing on women who are offered invasive diagnostic testing as a result of 'high risk' screening results, and who have been the subject of little research. Thirdly, the study site in Hong Kong provides a particularly interesting location, given limited research on antenatal screening in that part of the world, and Hong Kong's cosmopolitan environment that is reflected in the diversity of client population undergoing antenatal screening. Using conversation analysis we examine how aspects of the clients' diverse socioeconomic backgrounds and circumstances are interactionally managed in this setting, and how this might impact on decision-making.
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Affiliation(s)
- Alison Pilnick
- School of Sociology and Social Policy, University of Nottingham, Nottingham NG7 2RD, UK.
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22
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van den Bosch J, Oemardien LF, Srebniak MI, Piraud M, Huijmans JGM, Verheijen FW, Ruijter GJG. Prenatal screening of sialic acid storage disease and confirmation in cultured fibroblasts by LC-MS/MS. J Inherit Metab Dis 2011; 34:1069-73. [PMID: 21617927 PMCID: PMC3173643 DOI: 10.1007/s10545-011-9351-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 05/10/2011] [Accepted: 05/11/2011] [Indexed: 11/30/2022]
Abstract
Sialic acid storage disease (SASD) is an inborn error resulting from defects in the lysosomal membrane protein sialin. The SASD phenotypical spectrum ranges from a severe presentation, infantile sialic acid storage disease (ISSD) which may present as hydrops fetalis, to a relatively mild form, Salla disease. Screening for SASD is performed by determination of free sialic acid (FSA) in urine or amniotic fluid supernatant (AFS). Subsequent diagnosis of SASD is performed by quantification of FSA in cultured fibroblasts and by mutation analysis of the sialin gene, SLC17A5. We describe simple quantitative procedures to determine FSA as well as conjugated sialic acid in AFS, and FSA in cultured fibroblasts, using isotope dilution ((13)C(3)-sialic acid) and multiple reaction monitoring LC-ESI-MS/MS. The whole procedure can be performed in 2-4 h. Reference values in AFS were 0-8.2 μmol/L for 15-25 weeks of gestation and 3.2-12.0 μmol/L for 26-38 weeks of gestation. In AFS samples from five fetuses affected with ISSD FSA was 23.9-58.9 μmol/L demonstrating that this method is able to discriminate ISSD pregnancies from normal ones. The method was also validated for determination of FSA in fibroblast homogenates. FSA in SASD fibroblasts (ISSD; 20-154 nmol/mg protein, intermediate SASD; 12.9-15.1 nmol/mg, Salla disease; 5.9-7.4 nmol/mg) was clearly elevated compared to normal controls (0.3-2.2 nmol/mg). In conclusion, we report simple quantitative procedures to determine FSA in AFS and cultured fibroblasts improving both prenatal diagnostic efficacy for ISSD as well as confirmatory testing in cultured fibroblasts following initial screening in urine or AFS.
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Affiliation(s)
- Jeroen van den Bosch
- Department Clinical Genetics, Erasmus Medical Center, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
| | - Linda F. Oemardien
- Department Clinical Genetics, Erasmus Medical Center, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
| | - Malgorzata I. Srebniak
- Department Clinical Genetics, Erasmus Medical Center, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
| | - Monique Piraud
- Laboratoire des Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Centre de Biologie Est, Hospices Civils de Lyon, Bron, France
| | - Jan G. M. Huijmans
- Department Clinical Genetics, Erasmus Medical Center, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
| | - Frans W. Verheijen
- Department Clinical Genetics, Erasmus Medical Center, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
| | - George J. G. Ruijter
- Department Clinical Genetics, Erasmus Medical Center, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
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Saleem SN, Zaki MS. Role of MR imaging in prenatal diagnosis of pregnancies at risk for Joubert syndrome and related cerebellar disorders. AJNR Am J Neuroradiol 2010; 31:424-9. [PMID: 19942698 DOI: 10.3174/ajnr.a1867] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE JSRD are rare autosomal recessive brain malformations. We hypothesized that MR imaging can assess fetuses at risk for JSRD and might influence their diagnoses. MATERIALS AND METHODS We prospectively performed cranial MR imaging for 12 fetuses (mean GA, 23 weeks; SD, 3.7) at 25% recurrence risk for JSRD. We correlated prenatal MR imaging findings with postnatal MR imaging and clinical outcome. Retrospectively, we compared posterior fossa measurements of the cases with those of 24 age-matched fetuses with proved normal brain MR imaging. Institutional review board approval and consents were obtained. Statistical methods included a t test and ANCOVA tests. RESULTS Fetal MR imaging correctly diagnosed 3 cases at 22, 28, and 29 weeks of gestation as JSRD, and 9 cases as normal. In JSRD-affected fetuses, prenatal MR imaging detected narrow pontomesencephalic junction (isthmus) with deepening of the interpeduncular fossa and thick horizontally placed superior cerebellar peduncles (MTS), deformed anteriorly convex floor of the fourth ventricle, and midline cerebellar cleft in place of the hypoplastic vermis. Measurements on axial fetal MR imaging at pontomesencephalic junction, ratio of AP diameters of interpeduncular fossa to midbrain/isthmus, and ratio of the AP to transverse diameters of the fourth ventricle were significantly higher in JSRD-affected fetuses than in nonaffected cases and the control group. CONCLUSIONS MR imaging can diagnose JSRD in at-risk pregnancies by detecting posterior fossa signs. Measurements at the pontomesencephalic junction may enhance fetal MR imaging accuracy in diagnosing JSRD.
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Affiliation(s)
- S N Saleem
- Radiology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
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24
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Maeda K, Noguchi Y, Matsumoto F, Nagasawa T. Quantitative fetal heart rate evaluation without pattern classification: FHR score and artificial neural network analysis. Network 2010; 21:127-141. [PMID: 21138362 DOI: 10.3109/0954898x.2010.529396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- K Maeda
- Department of Obstetrics & Gynecology, Seirei Hospitals, Hamamatsu, Japan.
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25
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Wøjdemann KR, Larsen SO, Rode L, Shalmi A, Sundberg K, Christiansen M, Tabor A. First trimester Down syndrome screening: Distribution of markers and comparison of assays for quantification of pregnancy‐associated plasma protein‐A. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 66:101-11. [PMID: 16537243 DOI: 10.1080/00365510500406902] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE First trimester screening for fetal chromosomal disease is now possible using the maternal serological markers pregnancy-associated plasma protein-A (PAPP-A) and the free ss-form of human chorionic gonadotrophin (sshCG) in combination with the ultrasound marker nuchal translucency (NT) thickness. The availability of well-defined analytical methods and reference ranges for the involved parameters, and knowledge of the correlation between markers and clinical parameters, e.g. maternal weight, parity and age, are important for the design of efficient screening programs. MATERIAL AND METHODS Women (n = 2702), with singleton pregnancies, participating in the Copenhagen First Trimester Screening Study had PAPP-A and sshCG values determined and NT measured at a gestational age of 11 to 14 weeks, as determined from crown rump length (CRL). The distribution of gestational age-independent multiples of the median (MoM) of the parameters was defined and reference intervals established. Three methods for determination of PAPP-A, one manual in-house poly-monoclonal ELISA and two commercial semi-automatic double-monoclonal methods, i.e. PAPP-A for the AutoDelfia platform and PAPP-A for the Kryptor platform, were compared in 260 women. RESULTS All markers had log-normally distributed MoMs. Gestational age independent reference intervals were established. Maternal weight should be included in risk algorithms. The semi-automated PAPP-A assays (AutoDelfia and Kryptor) gave similar values, mean difference 10.5 %, whereas the manual assay gave higher values, mean differences 50.4 % and 41.0 %, respectively, CONCLUSIONS This calls for better standardization and a uniform quality control scheme that is focused on discriminatory ability rather than adherence to mean values from a large number of laboratories.
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Affiliation(s)
- K R Wøjdemann
- Copenhagen University Hospital, Department of Obstetrics and Gynaecology, Hvidovre Hospital, Denmark
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26
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Worley KC, Dashe JS, Barber RG, Megison SM, McIntire DD, Twickler DM. Fetal magnetic resonance imaging in isolated diaphragmatic hernia: volume of herniated liver and neonatal outcome. Am J Obstet Gynecol 2009; 200:318.e1-6. [PMID: 19110232 DOI: 10.1016/j.ajog.2008.10.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Revised: 08/07/2008] [Accepted: 10/03/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We sought to use magnetic resonance (MR) imaging (MRI) to estimate percentage of fetal thorax occupied by lung, liver, and other abdominal organs in pregnancies with congenital diaphragmatic hernia (CDH). STUDY DESIGN This was a retrospective study of pregnancies with isolated CDH referred for MRI between August 2000 and June 2006. Four regions of interest were measured in the axial plane by an investigator blinded to neonatal outcome, and volumes were then calculated. The percentages of thorax occupied by lung, liver, and all herniated organs were then compared with neonatal outcomes. RESULTS Fifteen CDH fetuses underwent MRI at a median gestational age of 29 weeks. Liver herniation was found in 93%. When the liver occupied > 20% of the fetal thorax, neonatal deaths were significantly increased. Percentages of lung and other herniated organs were not associated with outcome. CONCLUSION In our MR series of isolated CDH, neonatal deaths were significantly increased when > 20% of the fetal thorax was occupied by liver.
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Affiliation(s)
- Kevin C Worley
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
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27
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Al-Kasasbeh RT, Shapoval'nikov RA, Skopin DE, Shamasin MS. [Detection of fetus low-amplitude ECG signal for diagnosis of biological condition]. Med Tekh 2009:35-40. [PMID: 19437736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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28
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Abstract
The design, safety analysis and performance of a fetal visual stimulation system suitable for fetal and neonatal magnetoencephalography studies are presented. The issue of fetal, neonatal and maternal safety is considered and the maximum permissible exposure is computed for the maternal skin and the adult eye. The risk for neonatal eye exposure is examined. It is demonstrated that the fetus, neonate and mother are not at risk.
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Affiliation(s)
- J D Wilson
- Graduate Institute of Technology, University of Arkansas at Little Rock, Little Rock, AR 72204, USA.
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29
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30
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Kovavisarach E, Vichaipruck M, Kanjanahareutai S. Reagent strip testing for antenatal screening and first meaningful of asymptomatic bacteriuria in pregnant women. J Med Assoc Thai 2008; 91:1786-1790. [PMID: 19133509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To evaluate the diagnostic performance of reagent strip test as a screening test for asymptomatic bacteriuria (ABU) in pregnant women. MATERIAL AND METHOD Three hundred and sixty asymptomatic pregnant women who attended their first antenatal appointment at Rajavithi Hospital from August 1st to October 31st, 2005 were enrolled Those with symptoms of urinary tract infection within one month, those who had been prescribed antibiotics during the previous 7 days, and those with medical or obstetric complications, vaginal bleeding and a history of urinary tract diseases were excluded Urine specimens were collected by clean-catched midstream urine technique for urine dipstick and culture. RESULTS The prevalence of ABU was 10.0% The urine dipstick nitrite leukocyte esterase and combined test had a sensitivity of 16.7%, 75.0% and 16.7%, specificity of 99.1%, 67.9% and 99.4%, positive predictive value of 66.7%, 20.6% and 75.0%, negative predictive value of 91.5, 96.1% and 91.5%, accuracy of 90.8%, 68.6% and 91.1%, respectively. CONCLUSION Reagent strip testing indicated a fair sensitivity for routine antenatal screening for asymptomatic bacteriuria in pregnant women
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Affiliation(s)
- Ekachai Kovavisarach
- Department of Obstetrics and Gynecology, Rajavithi Hospital, Rajathewee, Bangkok 10400, Thailand
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31
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Quarello E. [Fetal MRI: indications, limits and dangers]. Gynecol Obstet Fertil 2008; 36:120-121. [PMID: 18191602 DOI: 10.1016/j.gyobfe.2007.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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32
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Parvaneh N, Teimourian S. Effectiveness of nitroblue tetrazolium (NBT) test. Arch Iran Med 2008; 11:129-130. [PMID: 18389564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Sharma BR, Gupta N, Relhan N. Misuse of prenatal diagnostic technology for sex-selected abortions and its consequences in India. Public Health 2007; 121:854-60. [PMID: 17610917 DOI: 10.1016/j.puhe.2007.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Revised: 02/14/2007] [Accepted: 03/08/2007] [Indexed: 10/23/2022]
Abstract
During 1800, the British Government found that there were no daughters in a village in the Eastern Uttar Pradesh region of India. According to the 2001 Census, there were less than 93 women for every 100 men in the Indian population. The prevailing concept that the birth of a female child can signal the beginning of financial ruin and extreme hardship for a poor Indian family is understandable. What is surprising is that even high-income families do not want a female child. The Government of India in its 10th Plan recognized the rights of the female child to equal opportunity, to be free from hunger, illiteracy, ignorance and exploitation. In the National Policy for the Empowerment of Women 2001, a policy framework was laid down for the elimination of discrimination against, and violation of, the rights of the female child. However, the situation continues to worsen, and studies have revealed that sex-selected abortions are practised among all communities despite enactment of laws prohibiting prenatal sex determination. In this paper, we examine the functioning and consequences of the misuse of this technology.
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Affiliation(s)
- B R Sharma
- Department of Forensic Medicine and Toxicology, Government Medical College and Hospital, 1156-B, Sector-32B, Chandigarh 160030, India.
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Mohamed H, Turner JN, Caggana M. Biochip for separating fetal cells from maternal circulation. J Chromatogr A 2007; 1162:187-92. [PMID: 17628577 DOI: 10.1016/j.chroma.2007.06.025] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Revised: 05/30/2007] [Accepted: 06/13/2007] [Indexed: 10/23/2022]
Abstract
Isolation of fetal cells from maternal circulation is the subject of intense research to eliminate the need for currently used invasive prenatal diagnosis procedures. Fetal cells can be isolated using magnetic-activated cell sorting or fluorescence-activated cell sorting, however no technique to specifically isolate and use fetal cells for genetic diagnosis has reached routine clinical practice. This paper demonstrates the use of a micromachined device to separate fetal cells from maternal circulation based on differences in size and deformation characteristics. Nucleated fetal red blood cells range in diameter from 9 to 12 microm can deform and pass through a channel as small as 2.5 microm wide and 5 microm deep. Although the white blood cells range in diameter from 10 to 20 microm, they cannot deform and are retained by the 2.5 microm wide and 5 microm deep channels under our experimental conditions. Fetal cells were isolated from cord blood and DNA analysis confirmed their fetal origin with ruled out maternal contamination.
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Affiliation(s)
- Hisham Mohamed
- Wadsworth Center, New York State Department of Health, Albany, NY 12201-0509, USA.
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Murabayashi N, Sugiyama T, Kusaka H, Sagawa N. Thoracoamniotic Shunting with Double-Basket Catheters for Fetal Chylothorax in the Second Trimester. Fetal Diagn Ther 2007; 22:425-7. [PMID: 17652929 DOI: 10.1159/000106347] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Accepted: 08/21/2006] [Indexed: 10/23/2022]
Abstract
The progress of a fetal severe pleural effusion at mid-trimester is extremely poor. We encountered a fetus that developed a severe left pleural effusion at 21 weeks of gestation. The pleural effusion was removed by thoracocentesis at 22 weeks. Cytology revealed abundant lymphocytes, suggesting chylothorax. However, a reaccumulation of pleural effusion with hydrops was subsequently noted, and a thoracoamniotic shunt with double-basket catheters was installed at 23 weeks. The pleural effusion decreased after 24 weeks and completely disappeared at 26 weeks. At 40 weeks of gestation, a female infant was born by vaginal delivery, with no evidence of pleural effusion. We would like to stress that thoracoamniotic shunt with double-basket catheters in the second trimester is effective for pleural effusion with hydrops.
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Affiliation(s)
- N Murabayashi
- Department of Reproductive Biology Science and Perinatal Medicine, Institute of Molecular and Experimental Medicine, Mie University Graduate School of Medicine, Tsu City, Mie, Japan
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Abstract
Although prenatal sonography remains the primary imaging method for screening fetal anomalies, fetal MRI with ultrafast imaging technique is a complementary imaging method as soon as the second trimester. It allows better tissue contrast images than does US, a large field of view of the foetus and is not limited by large maternal body habitus and oligohydramnios, without any risk for the foetus. In the future, the development of new techniques (diffusion-weighted imaging, proton MR spectroscopy) and faster sequences will make it possible to widen the indications i.e. cardiac, functional renal and cerebral imaging.
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Affiliation(s)
- M Brasseur-Daudruy
- Service de Radiopédiatrie, Centre Hospitalier Universitaire de Rouen, 1 Rue de Germont, 76031 Rouen cedex, France.
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Ayatollahi M, Tabei Z, Ramzi M, Kashef S, Haghshenas M. A fast and easy nitroblue tetrazolium method for carrier screening and prenatal detection of chronic granulomatous disease. Arch Iran Med 2006; 9:335-8. [PMID: 17061605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Analysis of the functional activity of neutrophils is of great importance in the differential diagnosis of patients with recurrent bacterial infections. It has long been established that stimulated polymorphonuclear leukocytes reduce nitroblue tetrazolium. Application of a simple and reliable nitroblue tetrazolium method that clearly differentiates the chronic granulomatous disease patients and heterozygote carriers in some groups suspected to have chronic granulomatous disease was investigated. METHODS This study consisted of 197 samples taken from 100 children (2 - 24-month-old) and 81 neonates (aged < 2 months) referred to our center either due to a suspected bacterial infection or suspected immunodeficiency. The sample also included 16 cord blood samples. Fifty healthy adult individuals were enrolled in this study and were diagnosed as normal control. Neutrophil reduction of nitroblue tetrazolium can be stimulated in vitro by protein kinase agonists such as phorbol myristate acetate, resulting in release of superoxide anion. RESULTS Phorbol myristate acetate is an exceptionally powerful stimulant and when used in conjunction with glass adherence, caused nearly all normal neutrophils to become transformed and reduced nitroblue tetrazolium to formazan deposits. Of 197 blood samples, 9 were diagnosed as having unrelated chronic granulomatous disease and 7 were carriers of X-linked or autosomal recessive chronic granulomatous disease. The carriers had a range of 15 - 75% stimulated neutrophils. CONCLUSION We have established a phorbol myristate acetate-stimulated nitroblue tetrazolium test for detection of chronic granulomatous disease patients, which clearly differentiates the chronic granulomatous disease patients from heterozygote carriers. The results in cord fetal blood indicate that this test may be used for antenatal diagnosis of affected boys, carrier females, and autosomal recessive variants of chronic granulomatous disease. The technique is simple, fast, inexpensive, and requires only a few microliters of blood.
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Affiliation(s)
- Maryam Ayatollahi
- Transplant Research Center, Shiraz University of Medical Sciences, P.O. Box 71935-1119, Shiraz, Iran.
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Guo WY, Ono S, Oi S, Shen SH, Wong TT, Chung HW, Hung JH. Dynamic motion analysis of fetuses with central nervous system disorders by cine magnetic resonance imaging using fast imaging employing steady-state acquisition and parallel imaging: a preliminary result. J Neurosurg 2006; 105:94-100. [PMID: 16922069 DOI: 10.3171/ped.2006.105.2.94] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The authors present a novel cine magnetic resonance (MR) imaging, two-dimensional (2D) fast imaging employing steady-state acquisition (FIESTA) technique with parallel imaging. It achieves temporal resolution at less than half a second as well as high spatial resolution cine imaging free of motion artifacts for evaluating the dynamic motion of fetuses in utero. The information obtained is used to predict postnatal outcome. METHODS Twenty-five fetuses with anomalies were studied. Ultrasonography demonstrated severe abnormalities in five of the fetuses; the other 20 fetuses constituted a control group. The cine fetal MR imaging demonstrated fetal head, neck, trunk, extremity, and finger as well as swallowing motions. Imaging findings were evaluated and compared in fetuses with major central nervous system (CNS) anomalies in five cases and minor CNS, non-CNS, or no anomalies in 20 cases. Normal motility was observed in the latter group. For fetuses in the former group, those with abnormal motility failed to survive after delivery, whereas those with normal motility survived with functioning preserved. The power deposition of radiofrequency, presented as specific absorption rate (SAR), was calculated. The SAR of FIESTA was approximately 13 times lower than that of conventional MR imaging of fetuses obtained using single-shot fast spin echo sequences. CONCLUSIONS The following conclusions are drawn: 1) Fetal motion is no longer a limitation for prenatal imaging after the implementation of parallel imaging with 2D FIESTA, 2) Cine MR imaging illustrates fetal motion in utero with high clinical reliability, 3) For cases involving major CNS anomalies, cine MR imaging provides information on extremity motility in fetuses and serves as a prognostic indicator of postnatal outcome, and 4) The cine MR used to observe fetal activity is technically 2D and conceptually three-dimensional. It provides four-dimensional information for making proper and timely obstetrical and/or postnatal management decisions.
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Affiliation(s)
- Wan-Yuo Guo
- Department of Radiology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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Whitworth MK, Bricker L. How to perform intrapartum fetal blood sampling. Br J Hosp Med (Lond) 2006; 67:M162-4. [PMID: 17017610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Melissa K Whitworth
- University of Liverpool, Department of Reproductive and Developmental Medicine, Liverpool Women's NHS Foundation Trust, Liverpool
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Azoulay R, Fallet-Bianco C, Garel C, Grabar S, Kalifa G, Adamsbaum C. MRI of the olfactory bulbs and sulci in human fetuses. Pediatr Radiol 2006; 36:97-107. [PMID: 16341529 DOI: 10.1007/s00247-005-0030-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Revised: 07/14/2005] [Accepted: 07/31/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND There is limited knowledge of the MRI pattern of the development of fetal olfactory bulbs and sulci. OBJECTIVE To describe the MRI appearance of olfactory bulbs and sulci in normal in vivo fetuses according to gestational age. MATERIALS AND METHODS Olfactory bulbs and sulci were retrospectively assessed on brain MRI examinations of 88 normal fetuses between 24 and 39 weeks gestational age. Two reference centres were involved in the study and both used routine protocols that included axial and coronal T2- and T1-weighted sequences at 1.5 T. The results were compared both with the commonly used neuropathological data in the literature and with personal neuropathological data. Pearson's chi-squared test or Fisher's exact test were performed. One case of olfactory agenesis associated with CHARGE syndrome was identified. RESULTS T2-weighted coronal sequences were the most sensitive for detecting olfactory bulbs and sulci. Olfactory sulci were significantly better detected from 30 weeks onwards (90.9-100%; P<0.001). MRI showed a posteroanterior development of these sulci. Olfactory bulbs were better detected from 30 to 34 weeks (80-90.9%; P<0.002). Comparison with neuropathological data confirmed the posteroanterior development of the sulci and showed an important delay in detection of the olfactory structures (bulbs and sulci). No difference was observed between the two centres involved. CONCLUSIONS To date, fetal MRI can depict olfactory sulci from 30 weeks gestational age onwards and olfactory bulbs from 30 to 34 weeks gestational age. This preliminary reference standard is useful to assess the normality of the olfactory system and to diagnose olfactory agenesis.
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Affiliation(s)
- Robin Azoulay
- Department of Radiology, Hôpital Saint Vincent de Paul, Paris V, Faculté de Médecine, 82 Avenue Denfert Rochereau, 75674 Paris Cedex 14, France.
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Lin SY, Chien SC, Su YN, Lee CN, Chen CP. Rapid genetic analysis of oculocutaneous albinism (OCA1) using denaturing high performance liquid chromatography (DHPLC) system. Prenat Diagn 2006; 26:466-70. [PMID: 16570240 DOI: 10.1002/pd.1439] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To present the prenatal genetic diagnoses and counseling for two cases of oculocutaneous albinism (OCA) type I family by detection of mutations in the OCA1 gene by denaturing high performance liquid chromatography (DHPLC) system and a review of the literature. METHODS All DNA samples were extracted from peripheral whole blood and amniocentesis-derived cells. Mutation analysis was performed for all five coding exons of the TYR gene, which were amplified by PCR. DHPLC was used for heteroduplex detection and sequence analysis was performed to demonstrate the mutation loci. RESULTS Case 1: After sampling of blood from the family members and performing amniocentesis of the fetus, it was demonstrated that the affected boy and the female fetus were shown to be compound heterozygotes for mutations in the TYR gene. In addition, it was shown that the parents were carriers of the two mutations. However, the couple chose to keep the baby. Case 2: Mutation analysis of the DNA of the siblings revealed two heterozygous mutations in the TYR gene. Her husband is free of the disease. According to the principles of autosomal recessive inheritance, the incidence of affected offspring is very low. CONCLUSIONS Herein we introduce a novel application for molecular diagnostic of DHPLC coupled with direct sequencing, which can provide an effective and exact diagnosis in patients with albinism. Clinicians should be cognizant of the risk of OCA inheritance by the offspring through careful identification of genetic mutations and the inheritance mode, both important to ensure comprehensive genetic counseling.
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Affiliation(s)
- Shin-Yu Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
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Abstract
OBJECTIVE This pilot study evaluated the use of 4-dimensional (4D) real-time ultrasonographic needle guidance for amniocentesis, chorionic villus sampling (CVS), cordocentesis, and intrauterine transfusions. METHODS Ninety-nine consecutive procedures were performed with 4D (real-time) multiplanar ultrasonographic imaging. Amniocentesis was done freehand in 3 orthogonal planes of view. Chorionic villus sampling, cordocentesis, and intrauterine transfusions were accomplished with a needle guide and 2 projected orthogonal planes. RESULTS Needle tip visualization in the A, B, and C orthogonal planes during amniocentesis was noted in 93%, 63%, and 69% of cases, respectively. When a needle guide was used during CVS and cordocentesis, the needle tip was always seen in the 2 projected orthogonal planes, and no lateralization occurred. Four intrauterine transfusions were done with the 4D technique. The only procedural complication in any patient was bradycardia from vessel spasm during an intrauterine transfusion, requiring a cesarean delivery. There were no statistical differences (P > .05) between the numbers of needle insertions required in the 4D group compared with a historical control group in which 2-dimensional ultrasonographic needle guidance was used. CONCLUSIONS In this feasibility study, a real-time 4D needle guidance technique was successfully used to perform amniocentesis, CVS, cordocentesis, and intrauterine transfusion. This appeared to contribute to the accuracy of needle placement by eliminating the lateralization phenomenon when a fixed needle guide attachment was used (for CVS and cordocentesis). Needle tip visualization was seen in each orthogonal plane in most freehand 4D amniocentesis cases. Future developments in 4D ultrasonographic technology may refine the utility of this technique for invasive obstetric procedures.
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Affiliation(s)
- Lawrence Dolkart
- Department of Obstetrics and Gynecology, Health Center for Women, 600 Fitch St, Suite 205, Elmira, NY 14905, USA.
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Abstract
OBJECTIVES Computerized automatic detection of pathologic fetal sinusoidal heart rate (FSHR) and its differentiation from physiologic FSHR is the purpose of this study. The results will be applied in the objective evaluation of fetal heart rate (FHR) with artificial neural network computer. METHODS FHR tracings of pathologic FSHR of 9 cases of fetal-neonatal anemia, death, or severe asphyxia, those of 7 physiologic FSHR followed by normal outcome, and those of 5 normal FHR are processed with fast Fourier transform (FFT) analysis after digitization, and their power spectrums are obtained. The peak power spectrum frequency (PPSF), peak power spectrum density (PPSD), the area under the power spectrum of 0.03125-0.1 Hz (La), the area under the whole power spectrum (Ta), and the ratio of La/Ta (%) of pathologic FSHR are compared to those of physiologic FSHR and normal FHR. RESULTS The La/Ta ratio and PPSD are significantly larger in the pathologic FSHR than those of physiologic FSHR and normal FHR. The true positive rate is 100%, false negative and false positive rates are 0%, respectively, when the pathologic FSHR is diagnosed by such combined criteria as 39% or more of La/Ta ratio and 300 or more of PPSD. CONCLUSION Pathologic FSHR is clearly separated from physiologic FSHR and normal FHR by the La/Ta ratio and PPSD obtained by FFT frequency analysis of FHR. Consequently, it is capable to automatically diagnose pathologic FSHR, and to apply it to neural network computer evaluation of FHR.
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Affiliation(s)
- Kazuo Maeda
- Professor Emeritus, Department of Obstetrics and Gynecology, Tottori University School of Medicine, 3-125 Nadamachi, Yonago, Tottoriken, Japan.
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Fogel MA, Wilson RD, Flake A, Johnson M, Cohen D, McNeal G, Tian ZY, Rychik J. Preliminary Investigations into a New Method of Functional Assessment of the Fetal Heart Using a Novel Application of ‘Real-Time’ Cardiac Magnetic Resonance Imaging. Fetal Diagn Ther 2005; 20:475-80. [PMID: 16113578 DOI: 10.1159/000086837] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Accepted: 12/20/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Because of quantitative echocardiographic limitations of fetal ventricular volumes as well as poor windows, we sought to determine if real-time magnetic resonance imaging (MRI) could be used. METHODS Real-time, functional, true fast imaging with steady-state precession, cardiac MRI was performed on 2 fetuses (one with hypoplastic left heart syndrome and one with ductal constriction). Fetal echocardiography was performed and cardiac index by Doppler was used to validate volume measures by MRI. RESULTS This technique was able to visualize the beating heart and assess ventricular volumes. Cardiac index and assessment of right ventricular hypertrophy and dilation by echocardiography were consistent with the ventricular volumes and right ventricular hypertrophy obtained by cardiac MRI. CONCLUSION Real-time, functional fetal cardiac MRI is possible and can be used to quantitatively assess ventricular volumes and cardiac index in utero.
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Affiliation(s)
- Mark A Fogel
- Division of Cardiology, Department of Pediatrics, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pa. 19104, USA.
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Kalakutskiĭ LI, Manelis ES, Rodkina IM. [Pulsoximetric sensor for diagnosis of intrauterine foetus state during parturition]. Med Tekh 2005:50-1. [PMID: 16144267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Detrimental changes in the degree of blood hemoglobin saturation with oxygen are important evidence of hypoxic states and can be regarded as objective indication to surgical delivery. A new method of fetal pulsoximetry was developed. This method is based on the use of a non-disposable atraumatic pulsoximetric sensor of reflectory type for diagnosis of intrauterine foetus state during parturition. The clinical trial of the system was carried out in 44 women in childbirth and revealed clear differentiation between hypoxic states.
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Jiang JP, Du M, Huang XY. [A test system of prenatal screen for Down's syndrome]. Zhongguo Yi Liao Qi Xie Za Zhi 2005; 29:109-11. [PMID: 16011115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This paper presents a test system of prenatal screen for Dow's syndrome, based on the quantitative test technology of gold immunochromotographic assay (GICA). The prenatal screen for Down's syndrome and the risk rate of Down's syndrome are given by calculating with the screen software. The test system features easy operation, fastness and individual tests.
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Affiliation(s)
- Jin-Ping Jiang
- Institute of Biomedical Instrument, Fuzhou University, Fujian Province
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Schneider U, Haueisen J, Loeff M, Bondarenko N, Schleussner E. Prenatal diagnosis of a long QT syndrome by fetal magnetocardiography in an unshielded bedside environment. Prenat Diagn 2005; 25:704-8. [PMID: 16052576 DOI: 10.1002/pd.1205] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The potentially life threatening long QT syndrome should be diagnosed during pregnancy to improve perinatal care. METHODS A patient with a family history for a hereditary long QT syndrome presented at 30 weeks of her first pregnancy with fetal bradycardia and a narrow oscillation bandwidth on cardiotocography without structural abnormalities of the fetal heart. Fetal magnetocardiography was performed with a prototype biomagnetometer/gradiometer device in a magnetically unshielded environment. The cardiac time intervals were determined in the averaged PQRST complex. RESULTS The QT time and the frequency-corrected QTc showed a marked prolongation to 380 ms and 0.52 s, respectively. The findings were confirmed in the postnatal electrocardiogram after spontaneous term delivery in a perinatal center. The causative mutation on chromosome 11 had been passed on to the newborn from his mother. CONCLUSION Bedside fetal magnetocardiography revealed the exact diagnosis of the long QT syndrome in a period of the gestation when the fetus was electrically isolated by the vernix caseosa that hinders electrocardiography. To patients at risk of fetal cardiac abnormalities, magnetocardiography can be offered as a non-invasive diagnostic bedside procedure. The diagnosis should trigger closer surveillance and delivery in a perinatal center.
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Affiliation(s)
- Uwe Schneider
- Department of Obstetrics, University Hospital, Friedrich-Schiller University, Jena, Germany.
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Rubod C, Robert Y, Tillouche N, Devisme L, Houfflin-Debarge V, Puech F. Role of fetal ultrasound and magnetic resonance imaging in the prenatal diagnosis of migration disorders. Prenat Diagn 2005; 25:1181-7. [PMID: 16353281 DOI: 10.1002/pd.1133] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate the contribution and limitations of fetal ultrasonography (US) and magnetic resonance imaging (MRI) for the diagnosis and management of migration disorders. METHODS Over a 5-year period, 14 fetuses with pathological migration disorders, without an infectious context, were taken care of in our centre. All underwent US; nine underwent MRI as well. Sonographic and MRI data were compared with neuropathological data. RESULTS The diagnosis of gyral disorders was obtained by US in 1/14 cases; other cerebral abnormalities were found suggesting neuronal disorder in the remainder. Cerebral MRI suggested gyral abnormality in eight of the nine cases. CONCLUSIONS US performance is increasing. MRI appears to be a promising method for the diagnosis of fetal migration disorders, giving better results than US. It may be recommended in cases of abnormal cerebral US findings or familial clinical history. However, interpretation of MRI can be tricky and the resulting diagnosis occurs late within the pregnancy.
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Affiliation(s)
- Chrystèle Rubod
- Clinique de Gynécologie Obstétrique, Hôpital Jeanne de Flandre, CHRU de Lille, France
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Comani S, Liberati M, Mantini D, Gabriele E, Brisinda D, Di Luzio S, Fenici R, Romani GL. Characterization of Fetal Arrhythmias by Means of Fetal Magnetocardiography in Three Cases of Difficult Ultrasonographic Imaging. Pacing and Clinical Electrophysiology 2004; 27:1647-55. [PMID: 15613129 DOI: 10.1111/j.1540-8159.2004.00699.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Characterization of ultrasound detected fetal arrhythmias is generally performed by means of M-mode and pulsed Doppler echocardiography (fECHO), sonographic techniques that allow only indirect and approximate reconstruction of the true electrophysiological events that occur in the fetal heart. Several studies demonstrated the ability of fetal magnetocardiography (fMCG) to identify fetal arrhythmias. We report on three women, studied after the 32nd gestational week, who were referred for fMCG because of unsatisfying fetal cardiac visualization with fECHO due to maternal obesity, fetus in constant dorsal position hiding the fetal heart, intrauterine growth retardation, and oligohydramnios. Minor pericardial effusion was present in the third patient and digoxin therapy was given. FMCG were recorded with a 77-channel MCG system working in a shielded room. Independent Component Analysis (FastICA algorithm) was used to reconstruct fetal signals. The good quality of the retrieved fetal signals allowed real-time detection of arrhythmias and their classification as supraventricular extrasystoles (SVE), with/without aberrant ventricular conduction and/or atrioventricular block. The time course of the fetal cardiac rhythm was reconstructed for the entire recording duration; hence, fetal heart rate variability could be studied in time and frequency. Since isolated extrasystoles may progress to more hazardous supraventricular tachycardias, the noninvasive antenatal characterization of, even transient, fetal arrhythmias and their monitoring during pregnancy can be of great clinical impact.
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Affiliation(s)
- Silvia Comani
- Institute of Advanced Biomedical Technologies, University Foundation G. D'Annunzio, Chieti University, Chieti, Italy.
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